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DISCHARGE SUMMARY

Name: Addres: TPA / Credit Party identification No.: Consultant Name : AGE/Sex : DATE OF ADMISSION : Principal Diagnosis : Operative Procedures : Chief Complaints : History of Present Illness : Past/Personal/Family History : History of Drug Allergy / Immunization : Physical Examination : Investigations : Summary of Treatment Discussion : Special Instructions / further treatment Advised : Chief Consultant R.M.O IP NO DATE OF DISCHARGE :

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